"Some cesareans are planned cesarean section maybe because they had so many cesareans before or they were told to have a cesarean for some reason these are planned or also called elective cesarian section. So the other types or the most common types of cesareans that we do are an emergency cesareans means we don't plan that cesarian we go thinking that women will have a normal delivery something or other changes and then the cesarean will become necessary for them. So they are called emergency cesarian sections so we have so many categories of cesarian sections also. Depending on how soon we have to do a cesarian we have categories like category one is the the cesarean is must to save the life of mother or the baby and it is so emergency that you have to have the baby out within 20 minutes. These are called category one cesareans that is an extreme emergency and we do drills to make sure that you know it can happen and the whole team is ready to do so. This is only when you think if the previous cesarean section is trying for a normal delivery and we think that car has ruptured then the baby can die very quickly. So this is only many times that we think minutes matter we do this category of cesareans. Sometimes a cord is a cord around the baby can come down the position of the baby is not right it's not head down it's across then the chances of this cord coming down with water break is high. So these are the times that we have to do in a very very emergency situation we call it as category 1. What is Category 2? When cesarean is necessary but it is not an emergency that we have to do in you know 10 - 20 minutes but it has to be done within that hour when we think baby is a little distressed but not so much that we have like you know the baby's heartbeat is down and not picking up. But baby's heartbeat is going down each time it's not correcting we think there is a problem with the baby. So we need to be a little hening things but not to an extent that you know everything is dropped down without consent we are going in wheeling straight to theater we call it. So usually we just done within 1 to 2 hours of decision these are category two what are category three cesarians which is it has to be done but to. So the time of women and the team we can plan like see we are planned to do aan but you come in an emergency with pains. So it has to be done but it is not an emergency baby is fine mother is fine but we have to do in that day. So around 6 hours or 8 hours we can plan based on various other things when you have had food to eat, you can wait till you are safe to have anesthesia and then get this done, we call it as category three. Category four is when you plan a cesarean you give a date you come and vision then we call it as category four. So this is categories of cesarean and now we have seen planned and unplanned emergency and elective cesarean. These are types of cesarean sections"

"Prolapse doesn't always mean it is only the own that is dropping down that certainly is one part of various problems that we see with Prolapse. So what all can come down uterus or the womb can come down that is called uteovaginal prolapse when that is coming down the weight of the uterus also drags the bladder down when that happens we call it as cystocele. Cysto means it's like cyst like thing that is bladder is like a fluid filled structure. So we call it as cyos is when bladder comes down what is rectos is rectum that is a motion passage when it comes along the back of the uterus then we call it as rectocele and sometimes the bowel that is higher up can also come down. We name it as entrocoele and where the tube where you pass urine it is not the bladder but the tube where you pass urine it is called urethra. When that also comes down we call it urethrocele. These are the names of various types of prolapse what if uterus is removed for some reason or the other then the top of the vagina can also come down in that case we name it as vault prolapse vault is the top of the vagina that is stitched at the time of uterus removal. So that can also drop down when there is no support. So these are various types of prolapse now let us look into stages of prolapse there are various grades and stages that were come long way over the years to try and differentiate between various degrees or stages of prolapse. So we can tighter our treatment and explain our women that what stage the prolapse is and how are we going to do the management of that particular prolapse so the recent and the most accurate means that we follow is a pop Q system. That is a pelvic organ prolapse it's a very quantification test. Very specific it is not varied so when we have to compare different doctors examining different women or the same women examined by different doctors we can quantify it very accurately when we follow this staging system. Usually staging is such that when uterus drops down but we cannot see outside then we call it as stage one when thump is felt at the entrance of the vagina but not completely outside. We call it as stage two . When some lump is coming down the vagina and you can can see and feel between your legs then it is stage three and when the total length of the uterus is outside drops down we call it as stage four . So this is a rough staging calculation that we use but POP Q is a very specific quantitative system that we practice. Most of the urogynecologist will practice this system that's a method of documentation before and after we can compare"

"So what can we do to try and prevent a prolapse? Prolapse is known to happen in many women almost if you reach the age of 80 one in two women will have a prolapse. If you are 50 1 in 3 to one in four women will have a prolapse. It is so very common and it makes us think. So there is nothing for us to prevent not really we can do something to try and reduce our chance of having a prolapse or reduce the intensity of having symptoms. So what are those? First thing is our general health. So how are we maintaining our health? Are we overweight are we underweight are we having a lot of problem like you know you not doing any regular exercise and having problems with diabetes, trying to control our own medical problems will go a long way if someone has a trouble. Having constipation all their life there is a lot of strain on pelvic floor that can lead to prolapse so what we have to do is try and reduce the risk of constipation. Drink lot of water have fiber rich food or when it is required use a laxitive. So the amount of strain that we have on the pelvic floor is reduced this is over the years if you imagine if you have that strain that will increase your chance of prolapse. The second thing is someone with chronic cough problem they always have an allergy or cough which goes on for months and months then that also has a lot of pressure on the pelvic floor. So we have to try and get the treatment faster so the pressure on the pelv pelvic floor is reduced this is about our general health . So what you have to do specifically to the pelvic floor is by doing Kegel's exercises. These are also called pelvic floor exercise these are done when as if you have to suddenly stop yourself from passing urine or motion. So that squeeze of that pelvic floor. Doing this often will help you to prevent the prolapse or when the prolapse is in very early stage we can reduce the worsening of the prolapse. How do we have to do it? Squeeze the pelvic floor as if you are stopping to pass urine and motion. Do it a quick one squeeze and relax. Same things has to be repeated around 8 to 10 times at least three times in a day. So how do you have to remember? You don't have to stop doing anything to do an exercise. This Kegel's exercise can be done when you are actually doing something else like you're sitting and eating same time. Remember and concentrate on your pelvic floor and that is all you have to do so make sure that becomes a habit and that is how we can prevent a prolapse"

"Pelvic Organ Prolapse occurs when the uterus or womb of a woman drops down, leading to a feeling of numbness in the vagina. Women may suddenly feel that something is descending, causing discomfort while walking and a sensation of something between their legs. This can lead to friction and significant discomfort when sitting, and may even lead to issues with urination because the descending organ can put pressure on the bladder, making it difficult to empty completely. This can result in recurrent urinary tract infections, and can also cause difficulty with bowel movements. If a woman experiences discomfort, feels a lump in the vagina, has difficulty passing urine or bowel movements, or experiences unexpected bleeding after menopause, it's important to seek consultation from a gynaecologist"

"After the delivery of the head, the shoulders are pulled gently downward. If this method fails to deliver the shoulders and if it requires extra manoeuvres to deliver the shoulders, then it's called shoulder dystocia. Once the head is delivered and if it slightly pulls back, it's called a turtle sign; then we have to suspect shoulder dystocia. It's a pretty rare condition. The risk factors are if the baby is more than 4 kilos. If the mother has diabetes, we can also be suspect. When there is a prolonged first stage of labour and maternal obesity but still shoulder dystocia can occur in any baby. Suppose there is a disproportion between the baby's weight. So, how do we manage regular shoulder dystocia? Drills are conducted in our hospital, and all the labour room staff are trained to manage shoulder dystocia. The first thing to do is to call for help, and we have certain manoeuvres; we give suprapubic pressure, and we also flex the thigh against the abdomen so much that the opens widens and there is room for the shoulder to come out. So the last assort used in case of shoulder dystocia is either clavicle fracture in severe cases or, you know, pushing the head from below and taking it out through a C-section. How do we prevent shoulder dystocia? Prevention is by controlling diabetes. In case you're diagnosed with gestational diabetes and avoid excess maternal weight gain, regular excess exercise, proper diet, and follow the instructions given by your doctor."

"The umbilical cord is a lifeline for a baby inside the womb. It is a connection between the naval and the placenta. So the blood flows, and the baby gets oxygen and nutrients through the umbilical cord. The umbilical cord entangles are very common because the cord around the neck is very common. It's 30% of the normal deliveries have a cord around the neck cord around the, neck is not a contraindication for normal delivery. The thought of a cord around the neck is worrisome to many pregnant women in the later stages of pregnancy. Around the neck is usually harmless, and it is because of random movements of the baby, or it's because of excessively long cords, or even because of excessive liquor around the baby. It is harmless, and it does not pose any problem for vaginal delivery. Cord entanglement around the other parts of the body only causes fetal distress. In the case of good uterine contractions, whenever the cord is compressed otherwise, cord entanglement, even around the other parts of the body around the trunk, is harmless. It doesn't matter whether it's a single loop of cord around the neck or, a double Loop or multiple loops. All patients can be delivered vaginally. What are the complications of cord entanglement that sometimes cause fetal distress? There is compression on the cord due to labour uterine contractions in cases of short cord, and a cord on the neck may prevent the baby's descent. Only in cases of fetal distress, but the patients have to be taken up for a C-section; otherwise, all patient's cords around the neck can be tried for vaginal delivery. There's no way to prevent cord entanglement. No sleeping positions which prevent cord entanglement are generally thought of as"